Changes in cardiorespiratory fitness and activity levels over the first year after discharge in ambulatory persons with recent incomplete spinal cord injury

Study design Secondary analysis of a clinical trial. Objectives To investigate changes in cardiorespiratory fitness (CRF) and activity level in ambulatory persons with SCI during the first year after discharge from inpatient rehabilitation. Setting Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway. Methods Thirty persons with incomplete SCI, all community walkers (25 males and 5 females, 18–69 years old) were recruited to a clinical trial of a 12 weeks home-based aerobic exercise program of either high or moderate intensity. During the last week of inpatient rehabilitation (baseline), participants performed a maximal exercise test on a treadmill (peak oxygen uptake; peak VO₂) and a 6-min walking test (6MWT). Also, total daily energy expenditure (TDEE) and daily amount of steps were measured continuously during 7 days in the participants’ homes. All tests were repeated after 3 and 12 months (post tests). Results Twenty of the 30 clinical trial participants performed baseline and both posttests and are included in this secondary analysis. We found no statistically significant between-group differences in the time course over the first year of either peak VO₂, 6MWT, or physical activity outcomes. Therefore, data from both exercise groups and the control group were merged for secondary analyses, revealing statistically significant increase over time in peak VO₂, 6MWT, and TDEE. The increase over time in the average daily steps did not reach statistical significance. Conclusions Ambulatory persons with SCI were able to increase their CRF levels over the first year after discharge from inpatient rehabilitation, despite a minimal increase in activity levels.

Matthijs F. Wouda, Eivind Lundgaard, Frank Becker, Vegard Strøm